GOP can’t even win the healthcare argument in the South

We’ve grown accustomed to thinking about the politics of health care lately in a rather binary, red-state/blue-state sort of way. In Democratic-led states, policymakers are creating effective exchange marketplaces, competition is helping consumers, Medicaid expansion is offering new hope to struggling families, and the uninsured rate is dropping quickly. In Republican-led states, progress is sporadic and slow.

But below the surface, looking at the debate this way is misleading, or at least, incomplete. As new polling from the New York Times and the Kaiser Family Foundation suggests, even in the deep South, voters aren’t actually buying what Republicans are selling on health care.

Despite strong dislike of President Obama’s handling of health care, a majority of people in three Southern states – Kentucky, Louisiana and North Carolina – would rather that Congress improve his signature health care law than repeal and replace it, according to a New York Times Upshot/Kaiser Family Foundation poll.

The poll also found that a majority of Kentucky residents – and a plurality in a fourth state, Arkansas – said they thought the health care marketplace in their state was working well, even as they expressed strong disapproval of the health care law.

The article quoted one Louisiana woman who said, “I’m a Republican, but I’m tired of them saying ‘Repeal, repeal, repeal.’”

Indeed, while the Affordable Care Act is not at all popular in these deep Southern states, locals hold surprisingly progressive views on health care policy in general. Repealing “Obamacare” in its entirety – the official line of the Republican Party – is the minority position in all four states. A majority of residents in these states, meanwhile, support Medicaid expansion and requiring private insurers to cover the full cost of contraception.

This stood out for me as perhaps the most interesting question: “Which comes closest to your view about the government’s role in providing health insurance for middle-income people under the age of 65 who don’t get insurance at work?”

Respondents were given choices: (1) Health insurance is people’s own responsibility and the government should not be involved; (2) The government should give them financial help to buy private insurance; and (3) The government should provide them with health insurance, as it does for seniors and many poor people.

In three of the four states, “the “government should provide them with health insurance” enjoyed plurality support. (The exception was Arkansas, but even here it was close.) If you combine options 2 and 3 to gauge support for government support in general, clear majorities of voters in each of the states are on board.

Remember, this isn’t Vermont, Massachusetts, and Hawaii we’re talking about here. Arkansas, Kentucky, Louisiana, and North Carolina are fairly characterized as “red” states in the South. President Obama lost all four of these states in 2012, and in most of these states, he lost by a lot.

Republicans have successfully tarnished Obamacare in the sense that it’s an unpopular “brand” name, but the larger point is the GOP is badly losing the policy fight. If they can’t convince voters in Arkansas, Kentucky, Louisiana, and North Carolina that the Republican position is the correct one, they have no credible chance of persuading the whole country.

Indeed, the evidence suggests GOP candidates may fare well in the battle for the 2014 midterms, but when it comes to health care, Republicans have already lost the war.